| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 470 ATLANTIC AVENUE, 13TH FLOOR BOSTON, MA 02210 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $39K | $12K | $50K | 2.35% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 116 HUNTINGTON AVENUE BOSTON, MA 02116 | DENTAL SERVICE OF MASSACHUSETTS, INC. DBA DELTA DENTAL OF MA | $8K | — | $8K | 3.79% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 116 HUNTINGTON AVENUE BOSTON, MA 02116 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $11K | $4K | $16K | 10.22% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 470 ATLANTIC AVENUE, 13TH FLOOR BOSTON, MA 02210 | EYEMED VISION CARE | $1K | — | $1K | 6.16% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 470 ATLANTIC AVENUE BOSTON, MA 02210 | EYEMED VISION CARE | $606 | — | $606 | 3.45% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 131 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 131 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 327 | $2.1M |
| Dental | DENTAL SERVICE OF MASSACHUSETTS, INC. DBA DELTA DENTAL OF MA | 349 | $223K |
| Vision | EYEMED VISION CARE | 353 | $18K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 131 | $153K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 131 | $153K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 131 | $153K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 327 | $2.1M |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 131 | $153K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 353 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.